YOUR HEALTH

Vision Plan

Regular eye examinations may not only determine your need for corrective eye wear, but could also detect other health problems such as glaucoma, diabetes, high blood pressure and high cholesterol.  Eye exams are a good preventative care measure.  Powell’s vision coverage provides in- and out-of-network benefits through Vision Service Plan (VSP).  However, keep in mind if you stay in-network you will benefit from greater savings.  The vision plan offers great discounts on services and supplies like eye exams, frames and contact lenses.  The plan will cover either contacts or lenses/frames, but not both within a plan year.

Please note, you will not receive a Vision ID card.  You simply tell the vision service provider that you are with VSP, and they will ask for your social security number to verify eligibility with VSP.

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Vision Benefit Plan Summary
In-Network Out-of-Network
Office Copay $25 $25
Services Once every plan year Once every plan year
Exams
Lenses
Exam Covered 100%* Covered up to $45*
Lenses Covered 100%*
Single Vision Covered up to $45*
Lined Bifocal Covered up to $65*
Lined Trifocal Covered up to $85*
Lenticular Covered up to $125*
Frames Covered up to $150* Covered up to $47
Contact Lenses
Medically Necessary Covered 100% Covered up to $210*
Elective Covered 100% up to $150 Covered up to $105*
*Included in $25 Copay.

 

Vision Plan Premiums
Weekly Semi-Monthly
Employee Only $1.62 $3.50
Employee + Spouse $3.23 $7.00
Employee + Child(ren) $3.23 $7.00
Employee + Family $4.85 $10.50

Resources

www.vsp.com

Group #: 12250635
800-877-7195